Saturday, June 22, 2013

Silver Added To Antibiotics

What follows are my thoughts on this article, http://www.latimes.com/news/science/la-sci-antibiotics-silver-20130620,0,6215677.story, which was written by Monte Morin and published in the Los Angeles Times on June 20, 2013 with the title, “Silver found to increase effectiveness of antibiotics”. The article reports that James Collins, a microbiology professor at Boston University, has found that silver, “when added to antibiotics in trace amounts makes the drugs as much as 1,000 times more effective in treating mice…” I have not yet obtained and read Dr. Collins’s study but am blogging on the LAT report because of the attention I am sure that it will get.

This is very exciting and promising. I hope that further studies, especially studies in humans, consistently confirm the results. If so, I will certainly endorse using silver this way and suspect that drug companies will want to add it to antibiotics and that before doing so they will do studies that show under what conditions it is beneficial, the amount that is beneficial and the amount that is toxic to the average person taking it.

However, assuming the Times article accurately reports the original research, there are some very important things to note.

The study didn’t use colloidal silver. It used silver nitrate. Silver nitrate was used before the advent of antibiotics. It didn’t work when taken internally although it did cause many cases of argyria, gray skin. When silver was studied back then, researchers discovered that mice don’t get argyria.

The Times reports that, “In one experiment, researchers induced peritonitis in mice by injecting them with E. coli cells. Of the mice treated with silver and vancomycin, 90% survived…Half of the mice that got silver died, along with 90% of the mice treated with antibiotics.” That sounds as if: silver nitrate and vancomycin very effectively treated E. coli peritonitis in mice; silver nitrate alone was effective in half the cases; and, vancomycin was effective in 10% of the cases. However, without knowing more details, I can’t conclude anything other than that the combination of silver nitrate and vancomycin sounds very promising indeed and should be studied further. Without knowing things like how long the animals were kept alive and monitored after the study, I have no idea whether or not any of the treatments cured them or just slowed the progression of their disease.

The story also notes that bacterial resistance to silver has been reported. That is true. It has been seen with approved topical silver drugs that have been used extensively to treat wounds, especially serious burns usually in hospitals burn units.

I find this study very relevant to this blog on naturopathic medicine because it strongly reinforces my entire point which is that the difference between the evidence-based or scientific medicine espoused by MDs, medical doctors, and the belief-based system of medicine embraced by NDs, naturopaths, is that MDs believe that the only way to evaluate drugs and therapies to see if they are safe and effective is to study them extensively and objectively before using them routinely. NDs on the other hand, believe in trying anything they think or hope may work either because it is natural and their philosophy holds that natural = beneficial or because, based on their own personal experience or testimony from someone else about his, they conclude that it works.

Additionally, scientists who develop drugs and therapies believe that the only way to do that is by doing exactly the kind of objective studies that Dr. Collins has done here progressing one step at a time whereas naturopaths and other alts jump right in using whatever suits their fancy playing Russian roulette with your life and health. See why naturopaths terrify me?

8 comments:

Rosemary, you are comparing apples and oranges. The reason the medical profession has to study their drugs is because of potential adverse effects especially the synthetic designer drugs. You put too much faith into pharmaceutical companies to have your well being in mind. Think thalidomide, Cox 2 inhibitors like vioxx, avandia a diabetic drug and many others.

I am not sure where you get the idea "alts jump right in using whatever suits their fancy playing Russian roulette with you life and health" Naturopathic medicine does not use a single modality as an approach to medicine, allopaths do this. The allopathic medical "belief" system is reductionist at times and has lost the art of medicine. I was just in DC at a naturopathic meeting were the speaker was an MD who is the Director of Integrative Medicine for the VA. She even stated the Naturopathic model of wholism is the way to go and will save the VA.

Naturopathic medicine is teaming up with institutions like UW medicine, many of our practitioners are PhD research and have MPH degrees. Go to the Bastyr website and read the research grants they have received and research in progress. I hate to say this but you make statements that are never backed up with hard fact and you make silly emotional statements like "snake oil" (really?!!), Russian roulette and etc. Come on you say you are fact based,but where are the facts except the Vermont formulary and the past inclusion of silver. You and I know if you googled cases of argyria in humans, it is self inflicted by either making it themselves or from supplement stores. Do your homework and call Bastyr, they would happily give you the titles of the pharmacology books, Botanical medicine texts with chemical constituents and mode of action along with the toxicology, along with internal medicine and pathology books that both the UW and Bastyr use.

The UW Medical clinics and Children's Orthopedic with Bastyr clinic rotate faculty, residents and students through each others clinics. Naturopathic graduates join fellowships in oncology at the Cancer Treatment Centers of America and receive specialty FABNO certificates to work in oncology. I could go on and on about our collaboration with the medical establishment and Integrative medicine, which by the way is where we are heading. Naturopathic medicine is not going away but is growing with over 400 graduates a year. Sadly, based on reading your blog,you most likely won't investigate what we really do and will follow my remarks with the same tired rhetoric. I will sign off now, in health Dr. N

Anyone who actually believes that the reason that scientists study drugs before using them is because of potential adverse effects caused by synthetics doesn’t know zilch about science or scientific medicine or drug development and certainly hasn’t comprehended what Dr. Collins, whose work is the subject of this blog, has done.

His experiments are typical of those medical scientists have been doing routinely for about 150 years. He is testing substances to see if they offer benefits. He started in the lab, moved to animals and, if all goes well, will go on to humans. At the point he is at now, he hasn’t even gotten into studying whether or not the product he is working with causes adverse effects that will become manifest with long term use. He has noted, of course, that it doesn’t kill or seriously injure mice quickly, but that is about as much safety data as he has now.

Anyone who has read and understood medical journals, medical textbooks or studied the history of scientific medicine and drug development understands this. They know that studying drugs and therapies is what medical scientists do. It is how they spend their lives, their working hours. They do it to learn, to find cures, to solve problems, to test their beliefs and hunches. They do it one itsy bitsy step at a time and they report their results to see if others can replicate them.

Using this scientific method doesn’t guarantee that natural or synthetic drugs will never injure or kill you. That is why drugs are monitored once they are marketed. However, intensely studying drugs before they are used greatly improves the odds in your favor which is all we can ask for in this world.

The fact that an ND who presumably has earned a degree from an accredited ND school doesn’t know any of this demonstrates my point. NDs know nothing about scientific medicine and certainly don’t practice it. They play Russian roulette with the life and health of their patients.

N, you state, “I am not sure where you get the idea "alts jump right in using whatever suits their fancy playing Russian roulette with your life and health"

I discovered that reading your Vt Naturopathic Formulary which I’ve pasted here, http://rosemaryjacobs.com/naturopaths.html. It includes many examples, however, I think that colloidal silver, cobalt, nickel, silver and tin are the most egregious.

It also comes from your use of homeopathy and botanical drugs, both of which are taught in your schools and make up a large part of the practices of licensed naturopaths. I believe I’ve covered the fact that these modalities are not evidenced based extensively in this blog in many places such as in my blogs on my comments to legislative committees and the one on deadly folk medicine, read botanical, http://rosemary-jacobs.blogspot.com/2012/05/deadly-folk-medicine.html.

Bastyr may be getting grants now to do research, but that doesn’t change the fact that for decades they have used and promoted things like silver, cobalt, nickel, tin, botanical and homeopathic remedies for which there is either no evidence of safety and efficacy or evidence that they are useless and/or will cause harm. Anyone who believed in science or just simple objective evidence gets an upset stomach just thinking of that.

I have spoken with lots of people who have gotten argyria recently from supplements as well as to their relatives and health care professionals who have seen them. I have read about their cases in medical journals and read stories about them on the Internet. Some of them have even been interviewed by the same journalists as I have. They all got argyria because they believed that silver was a “natural remedy”. As far as I can tell, that notion came from naturopaths, the licensed and unlicensed kind. Believing that NDs are the source of all that misinformation, I believe that NDs are responsible for the wave of new cases of argyria we have seen recently.

I collect old medical textbooks because I am fascinated by the history of medicine, the kind of studies scientists like Dr. Collins do and the way in which evidence-based (scientific) medicine has developed over the years.There are literally tens of thousands of such study published by those who believe in scientific or evidence-based medicine and very few, almost all of which are recent and of dubious quality, from alts including NDs.

I have the 1987 and 1999, reprinted in 2000, editions of The Textbook of Natural Medicine by Pizzorno & Murray which Bastyr listed on their site as the “gold standard of natural medicine”. Yet I have seen a comment by a person claiming to be a student at the school who says she has never heard of the book. That is one reason I would really appreciate naturopaths telling me what textbooks they use or seeing them listed on the accredited school sites. Actually, it strikes me as very odd that none of the NDs reading my blog ever comes forward with what should be basic public information.

Opening the 1987 edition randomly, I see the heading “Emergency Cart Contents”. Section IV A includes a list of about 2 dozen “homeopathic medications”. It is followed by a chapter on homeopathy. Most every scientist, including chemists and physicists as well as medical scientists, I know thinks homeopathy and homeopathic remedies are a big joke since almost none contain any active ingredients. Yet NDs are instructed to include them on an emergency cart? I see scientists rolling on the floor.

On p. 1495 of the 1999 edition of the Pizzorno textbook under “Therapeutic approach for all types of pneumonia”, I see lists of supplements, botanicals and “physical therapy”. The last one includes mustard poultices, something I have unpleasant memories of from childhood. Lobelia inflata and echinacea are included under botanicals.

My grandfather as well as many others died of pneumonia in the 1920s when the only treatments available were “natural ones”. They didn’t work. My mother was successfully treated for pneumonia 3 times with antibiotics and nothing else in the late 1990s. My grandfather was in his 40s. My mother in her 80s. My relatives weren’t exceptions. That is why most everyone discarded natural remedies. They progressed. They moved on. Then the New Agers came and decided no one knew anything except them. They were going to show us all. They were going to reinvent the wheel. They are still trying. They are learning that their natural remedies don’t work and adopting drugs and diagnostic devices developed by scientists and using it along with the old garbage. They are learning that third party payers want objective evidence of safety and efficacy and are scrambling to find it, but also lobbying to force third parties to pay even when they don’t have it.

I know perfectly well that “integrative medicine” is in vogue now, but I haven’t seen any evidence of its being anything other than a way for what used to be scientific institution and some of their scientists and MDs to partake of the billion $$$ “dietary supplement”, “alt med” gravy train. Its a very easy way to fleece customers.

Rosemary,You probably haven't gotten a list of textbooks because no one wants to take the time to go through all the syllabi from all the classes we took in ND school and type up the required texts listed on them. It would take more time than it's worth. Call one of the schools if you're interested. I'm sure the registrar's offices would share that info. Perhaps they keep records of required texts in a more condensed form than the syllabi which the students are given. As far as the Textbook of Natural Medicine goes, I don't recall it ever even being a "recommended" text on the syllabi of any of the classes I took, but I remember it being occasionally mentioned.

In response to your point about natural treatments of pneumonia- I think you are misunderstanding the practice of naturopathic medicine. NDs are trained to preform physical exams and utilize diagnostic laboratory work and imaging, so we can assess how severe the person's case is when they present to the office. There may be time to try natural methods first, with the understanding that good communication between doc and patient needs to occur (to assess if the patient is responding to the natural treatments in an appropriate time frame), and that prescription meds may be necessary. (And yes, we're trained in pharmacology, and in the use of prescription medications for conditions normally handled by a PCP.) Prescription meds are useful tools, but just as with any other form of treatment, the doc needs to evaluate the individual and work with them to determine the most appropriate treatment plan (i.e., what is effective, what is safe, how is the patient presenting, what are the risks of treatment vs. not-treating, etc.). I certainly hope there aren't any licensed NDs out there recommending a natural treatment plan (regardless of what specifically is recommended) to patients with pneumonia without following up with them to assess progress and either rx or refer if necessary. It wouldn't be safe, and it wouldn't be consistent with our training.

Regarding calling one of your schools, I really want to talk to NDs. I have wanted to do that and tried hard to do that ever since I saw silver in your VT approved formulary, but aside from one ND I spoke with at a conference, none will talk to me. And please don’t tell me that is because I’m rude. I believe I started out polite but became angrier and angrier by the lack of response I got to my very real concerns about the very serious danger to human beings posed by your use of silver.

But it gets worse. After hearing VT NDs deny to legislators that NDs use silver when I know that is not true, I completely lost all trust in naturopaths. For that reason I now want our communication open for anyone interested to read.

From your remarks on textbooks it sounds to me as if your schools don’t have primary sources, as if you use many textbooks and frequently change them. Is that true? If so, it suggests that the whole profession is pretty much in flux. I consider that important information and it is another reason why I’d really appreciate it if NDs took the time to tell me themselves something like, When I was at such and such a school in such and such a year I remember using A, B, C & D.

I understand very well that NDs do physical exams, diagnostic imaging and lab work. I also understand that they treat people and that they do that with synthetic drugs (depending on the state they work in), “natural medicine” that includes Chinese botanicals and “dietary supplements”, homeopathy, hydrotherapy, nutrition and lifestyle counseling, etc. Since they claim to treat “the whole person”, I assume, as many themselves state, that means they include the mind, body and soul, employing techniques like teaching relaxation, stress reduction, things that are in the domain of psychology and religion. What I can’t find out is how specifically NDs treat anything in particular or what specifically they teach people. The more I hear the more I suspect that it is all very subjective based on what each individual ND thinks is appropriate for a particular person at a particular time in a particular place. I will continue assuming this until NDs tell me otherwise and show me how to verify their claims independently. (If they used standard textbooks, primary sources, I would find my answers in them and not need to have NDs tell me themselves.)

Regarding the treatment of pneumonia, you say, “There may be time to try natural methods first,…” That’s fair enough if you have solid, scientific evidence showing that there are effective natural methods to treat pneumonia. My whole point was that there certainly weren’t any before the advent of antibiotics. I am not aware of any developed since then although I suspect that before the advent of antibiotics some people did recover without treatment because that is true of so many diseases. I’m not going back to pull Pizzorno, but if I remember correctly, he wasn’t suggesting using natural methods to treat pneumonia in mild cases. He was suggesting using useless therapies, and at least one very unpleasant one, as adjuncts to therapies that have been shown to be safe and effective.

If you have been trained to use natural methods to treat pneumonia before it becomes severe, please tell me what they are and provide references to a body of evidence, good scientific studies consistently giving the same results, that show that those methods are safe and effective.